Background Raised blood pressure (and heart rate (HR)) due to anxiety in a clinical situation is well described and is called the white coat effect (WCE). It is not known whether the pain and anxiety that results from trauma causes a measurable WCE.
Methods A sample of patients with a non-haemorrhagic injury from the Trauma Audit and Research Network (TARN) was compared with a healthy, non-injury sample from the Health Survey for England (HSE) databases. Two-way analysis of variance with rank transformation of data was used to compare systolic blood pressure (SBP) and HR between the groups at different ages. In the injured group, the SBP and HR were also compared between spinally immobilised and non-immobilised patients.
Results There was a statistically significant difference between the groups for both HR and SBP (p<0.001). Median HR remained approximately 10 bpm higher in the TARN set when compared to the HSE set, irrespective of age. The difference for SBP was not considered clinically relevant (the highest was 5 mm Hg). There was no significant difference between immobilised and non-immobilised patients, for either HR or SBP (p=0.07 and 0.3, respectively).
Discussion Median HR remained approximately 10 bpm higher in the TARN (injury) set compared to the HSE (non-injury, control) set, irrespective of age. Understanding that HR reacts in this way for mild to moderately injured patients is important as it will affect clinical interpretation during the initial assessment.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.